Provider Demographics
NPI:1942468400
Name:KAREN A MILLER, LICSW, PLLC
Entity Type:Organization
Organization Name:KAREN A MILLER, LICSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-679-4551
Mailing Address - Street 1:275 SE CABOT DR
Mailing Address - Street 2:SUITE B206
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-3715
Mailing Address - Country:US
Mailing Address - Phone:360-679-4551
Mailing Address - Fax:360-679-9341
Practice Address - Street 1:275 SE CABOT DR
Practice Address - Street 2:SUITE B206
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-3715
Practice Address - Country:US
Practice Address - Phone:360-679-4551
Practice Address - Fax:360-679-9341
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-30
Last Update Date:2008-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004003251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health